US District Court Judge Matthew Kacsmaryk of Amarillo, Texas, known for right-wing decisions, will rule on the future availability of mifepristone.
Access to medical abortion in the United States is under threat due to a lawsuit filed by several anti-abortion organizations and doctors, and a ruling could come as early as later this week. The plaintiffs in the case, Alliance for Hippocratic Medicine v. The US Food and Drug Administration are seeking to revoke FDA approval for mifepristone – one of two drugs used in medical abortion – and the drug pulled from the market nationwide.
“This case is a politically motivated attack to remove mifepristone from the market, which could have far-reaching consequences for patient access to abortion nationwide,” said Danika Severino Wynn, a certified nurse midwife, provider of abortions and vice president of abortion access. to the Planned Parenthood Federation of America. “Mifepristone is safe, effective, and has been used by more than 5 million people since the FDA approved it more than 20 years ago.”
If the court rules in favor of the plaintiffs, mifepristone would no longer be available in any state, even where abortion has remained legal. “Alliance for Hippocratic Medicine v. FDA could have catastrophic implications for the future of reproductive freedom and could impact more than 64 million people and their families,” said Ally Boguhn, director of communications for NARAL Pro-Choice America. “To make matters worse, the case will be decided by a judge hand-picked by Donald Trump to dismantle our basic freedoms. If mifepristone is taken off the market, the impact will be swift and devastating.”
The Alliance for Hippocratic Medicine is made up of anti-abortion organizations and doctors, including the American Association of Pro-Life Obstetricians and Gynecologists, and are represented in the lawsuit by the Alliance Defending Freedom, which was designated a hate group by the Southern Poverty Law Center. “The fact that this lawsuit, filed by a far-right hate group and heard by a Trump-appointed judge, could revoke FDA approval for mifepristone is shocking but not surprising to any of us in the fight for reproductive freedom. “. said Melissa Fowler, chief program officer at the National Abortion Federation. “This lawsuit has nothing to do with how effective or safe this drug is and everything to do with anti-abortion extremists who continue to play politics with our lives.”
The case was filed in Amarillo, Texas, “100 percent deliberately” to be heard by US District Court Judge Matthew Kacsmaryk, said Kirsten Moore, director of the Expanding Medication Abortion Access Project, an advocacy organization. “This is a judge who is registered as opposed to abortion. She has a very clear set of biases and preconceptions about abortion. Judge Kacsmaryk has issued rulings barring teens from accessing birth control confidentially, without parental consent, and has a history of issuing right-wing court decisions, including weakening protections for LGBTQ people.
Despite widespread outrage over this lawsuit, the future availability of mifepristone is now in the hands of this single judge. Supporters are “bracing themselves for a negative outcome across three different lanes,” Moore said. “Legally, we fully anticipate that the Justice Department will appeal to stay the decision. The practical response from service providers will be to ensure patients know they can still receive misoprostol,” which is the second drug used in a medical abortion and “even on its own, it can still be effective,” Moore said. supporters are also “organizing to make sure the White House is sending a clear message and supporting the FDA’s approval authority.”
If mifepristone is no longer available, the impact will be felt in every state. “Everyone will be affected by whether their state is protective or restrictive of abortion care,” said Elizabeth Nash, state policy analyst at the Guttmacher Institute. Their new report, 10 States Would Be Hit Especially Hard by a National Ban on Medical Abortion Using Mifepristone, shows that there will be hurdles even in states where abortion is still legal. In these states, which include Georgia and Vermont, “there could be a particularly steep drop in the share of women of reproductive age living in counties with an abortion provider if abortion-only drug providers don’t start offering an misoprostol-only regimen, Nash said. Abortion is already banned or unavailable in 14 states, and “we expect as many as 24 states total to ban it in the coming months. Providers are preparing to use a misoprostol-only regimen.” However, it is unclear whether all current providers will offer abortion care using only misoprostol and to what extent patients would adopt this method.Looking forward, we know that opponents of abortion are trying to ban access to any medications used for abortion, so there could be misoprostol attacks coming.”
If mifepristone is no longer available, “the impact will disproportionately affect people who already have less access to sexual and reproductive health care, such as people who live in rural communities and people who are Black, Indigenous, Latino and other people of color,” said Martha Spieker, associate director of federal advocacy communications at the Planned Parenthood Federation of America.
Medical abortion with mifepristone “offers specific benefits that could make it a preferable option for people with limited financial resources,” Nash said. “Because mifepristone can be prescribed via telehealth in many areas and taken safely in the privacy and comfort of one’s home, this method can help reduce costs associated with transportation or child and family care, and allows for scheduling more flexible”.
Providers are already overstretched, and “at a time when we should be devoting our time and resources to providing abortions, we’ve spent the past few weeks meeting with attorneys, updating policies, and holding staff trainings in preparation for a wrongful ruling.” and the potential impacts on our ability to provide medical abortions,” said Zack Gingrich-Gaylord, director of communications at Trust Women, an abortion provider and advocacy organization with clinics in Wichita, Kansas, and Oklahoma City, Oklahoma. Their Wichita clinic recently received 16,000 calls in one day. “Our work is constantly being forced to change, not for medical reasons, but because of the decisions of politicians or judges who simply don’t like abortions. Ultimately, creating barriers and reducing options to allow people to terminate their pregnancies safely continues to eliminate access to abortion at a time when clinics are already overwhelmed and unable to provide care for all those who try to abort.
There is also concern that this case could generate misinformation about the safety of medical abortion. “There’s already so much confusion about what’s legal and what’s not in every state, and we’re even getting phone calls from people in New York wondering if abortion is still legal there,” said Yamila Ruiz, senior director of communications and public affairs for the Latin National Institute for Reproductive Justice. “Latinos (and Latinos) are especially dependent on social media for communication and information and therefore are disproportionately exposed to disinformation.”
There are other potential negative consequences of this lawsuit beyond even the possibility of mifepristone being banned. This lawsuit “really undermines the authority of the FDA and would also be a concern for drug companies planning drug development,” said Dr. Daniel Grossman, director of Advancing New Standards in Reproductive Health, a research program at the University of California, San Francisco focused on abortion and reproductive health care. “The idea that you can go through the entire approval process and get a drug approved, only to have an advocacy group object to the treatment for any reason before a rogue judge who could revoke the approval – it’s ridiculous. The argument in this lawsuit, which questions the safety of mifepristone, is the same argument that has been used in some state laws and court decisions that have placed restrictions on medical abortion. These arguments were rejected by the FDA when the agency reviewed them because they are not based on science.”
This lawsuit is another tool that abortion advocates are using in their crusade to ban all forms of abortion assistance in every part of the United States. “For years, the anti-abortion movement has built a well-organized, well-funded machine and hatched plan to attack abortion access at all levels of government,” said Ashley Underwood, director of Equity Forward, a responsible organization that produces surveys research focused on global human rights, gender equality and sexual and reproductive health, rights and justice. “They have infiltrated state houses and Congress, and the judicial branch is not immune. We saw it when SCOTUS took away our abortion rights with Dobbs, and we’re seeing it again in this lawsuit. They will stop at nothing to advance their agenda.”
On Feb. 14, Sen. Mazie K. Hirono, D-Hawaii, and Sen. Elizabeth Warren, D-Mass., along with 10 other senators, sent a letter to President Biden urging new measures to protect access to abortion , including the use of “every legal and regulatory means at their disposal to maintain… [mifepristone] on the market.”
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